Treatment-related alterations of imaging findings in osteoid osteoma after percutaneous radiofrequency ablation

Skeletal Radiol. 2019 Nov;48(11):1697-1703. doi: 10.1007/s00256-019-03185-1. Epub 2019 Mar 6.

Abstract

Objectives: We aimed to report the long-term outcomes of osteoid osteoma patients and to determine CT and dynamic contrast-enhanced MR imaging characteristics of radiofrequency ablation (RFA) treatment related changes of osteoid osteoma between follow-up periods.

Materials and methods: Thirty patients (seven female, 23 male) who underwent CT-guided RFA of osteoid osteoma were included. Follow-up imaging examinations were divided into two subgroups; first (1-3 months) and second (> 6 months) periods. Nidus size, calcification, cortical thickening, maximum signal intensity (SImax), time of SImax (Tmax), slope of signal intensity-time (SIT) curves were noted. CT and dynamic MR imaging findings were compared between follow-up periods.

Results: Clinical success rate was 100%. The mean of OO nidi size was 5.85 ± 1.98 mm before treatment. There was a significant difference for OO nidi sizes between pretreatment and second follow-up period examinations (p = 0.002). SImax and slope of SIT curves of all patients (100%) showed decrease on follow-up MRIs. There was a significant decrease for SImax values between pretreatment and second follow-up period. There was a significant decrease for slope of SIT curves between pretreatment and both follow-up periods.

Conclusions: RFA is an effective and safe treatment choice for osteoid osteomas. On follow-up imaging, slope of SIT curve and Tmax have the most important positive predictive value for long-term outcomes and single dynamic contrast-enhanced MRI within first 3 months after treatment may be sufficient for symptom-free patients.

Keywords: Computed tomography; Follow-up; Magnetic resonance imaging; Osteoid osteoma; Radiofrequency ablation.

MeSH terms

  • Adolescent
  • Adult
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / surgery*
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / surgery
  • Catheter Ablation / methods*
  • Child
  • Child, Preschool
  • Contrast Media
  • Female
  • Humans
  • Image Enhancement / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Osteoma, Osteoid / diagnostic imaging*
  • Osteoma, Osteoid / surgery*
  • Reproducibility of Results
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Young Adult

Substances

  • Contrast Media